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The New Normal Is That Nothing Is Normal (2021 Health Law Section Program)

8:55        Welcome and Introductions

9:00        Exploring the New Stark and Anti-Kickback Landscape: Flexibilities for Providers and Value-Based Care in a Post-COVID Environment

Kelsey U. Jernigan, K&L Gates LLP, Research Triangle Park
Steven G. "Steve" Pine, K&L Gates LLP, Research Triangle Park

While providers navigate a sea of waivers and exceptions related to COVID-19, significant changes to the federal Stark Law, Anti-Kickback Statute and Civil Monetary Penalties Law are shaping provider collaboration and the fraud and abuse landscape for years to come. These long-awaited final rules contain significant accommodations for value-based care models, while modernizing the regulations in an aim to align with the current health care industry. This presentation explores how the health care industry can utilize these accommodations to pursue value-based care in a post-COVID environment.

10:00      Break

10:10      Telehealth Opportunities — For Patients, Profits, Personnel, Prosecutions and Penetration‡

Barry S. Herrin, Herrin Health Law PC, Atlanta, GA
Jennifer B. "Jenny" Markham, UNC Healthcare System, Chapel Hill
Allen T. O'Rourke, Robinson Bradshaw & Hinson PA, Charlotte

COVID accelerated the adoption and deployment of remote diagnostic (telehealth) services faster than anyone thought possible. However, the speed of telehealth' adoption also created opportunities for health care fraud and the proliferation of cybercrime throughout the healthcare industry. The panelists discuss how health care providers have operationalized telehealth in their service offerings, continuing challenges in telehealth reimbursement, the growth of telehealth-enabled fraud, the impact of cybercrime on the increased "attack surface" created by telehealth, and adjustments required due to more workplaces being converted to "work from home" and away from traditional office environments.

11:40      Lunch Break

12:10      Managing Health Care Internal Investigations

Pearlynn G. Houck, Robinson Bradshaw & Hinson PA, Charlotte
Jonathan C. Krisko, Robinson Bradshaw & Hinson PA, Charlotte

An effective internal investigation depends upon the expertise and competence of a company's legal counsel and investigation team. Internal investigations have become larger and more complex, particularly in the healthcare industry, which presents unique risks of legal and regulatory pitfalls. The presenters discuss best practices in conducting healthcare-related investigations and the range of issues that may arise including privilege, document retention and preservation, confidentiality, employment-related complexities, and additional issues resulting from the COVID-19 pandemic.

1:40        Break

1:50        An Ounce of Prevention: Best Practices for an Effective Compliance Program

R. Ross Burris III, Polsinelli, Atlanta GA
Neal I. Fowler, United States Attorney's Office, Raleigh
Ted Lotchin, WakeMed Health & Hospitals, Raleigh

In an industry that is always evolving, one constant remains: a robust compliance program is the best medicine for protecting against serious regulatory risks and promoting ethical behavior. Panelists discuss best practices for implementing an effective compliance program and review recent guidance from the Department of Justice and the Office of the Inspector General. Dive into a discussion on strategies for developing, implementing, and improving corporate compliance initiatives.

2:50        Break

3:00        Health Care Policy: The Winding Road Ahead

Karishma S. Page, K&L Gates LLP, Washington, DC

In the midst of a pandemic, a new president, and many other changes inside the Beltway, including a likely Supreme Court decision on the constitutionality of the Affordable Care Act, health care policymakers have their hands full in 2021. This session discusses what to expect from President Biden's administration, how the pandemic will help shape health policy in 2021 and beyond, the current state of the Affordable Care Act, and other key health policy developments that will undoubtedly have a dramatic effect on the health care industry going forward.

4:00        Adjourn

‡ Indicates portion providing Technology Training credit


Description

The ongoing pandemic and the transition to a new presidential administration are expected to have significant and lasting impacts on the health care industry, requiring health care providers, payors, and policymakers, and the lawyers who serve them, to continually evolve in the coming months and years.

Contributors

  • Gina L. Bertolini

    Gina L. Bertolini, K&L Gates LLP, Morrisville

    Gina is a partner in the Research Triangle Park officer and concentrates her practice exclusively on health law; primarily representing academic medical centers, hospitals, and health systems. She counsels senior health system and academic medical center leadership on a variety of governance, transactional, operational, and regulatory matters. In this context, she advises hospital, health system, and academic medical center clients on a multitude of legal matters, including state and federal regulatory affairs, such as federal Stark and anti-kickback statutes, EMTALA, HIPAA, and the Affordable Care Act.

    Click here for more information about Gina.

  • R. Ross Burris III

    R. Ross Burris III, Polsinelli, Atlanta GA

    Ross benefits clients by applying a strong business acumen to understanding the goals and challenges clients face, and by leveraging a commanding ability to counsel on intricate legal matters. His experience includes advising clients regarding the complex and ever-changing federal and state regulatory environment. Ross approaches each issue with a practical application that is unique to the client’s context, and draws on a strong background of working with numerous regional and national health care providers

    Click here for more information about Ross.

  • Sarah B. Crotts

    Sarah B. Crotts, Parker Poe Adams & Bernstein LLP, Charlotte

    Sarah has more than a decade of experience advising hospitals, physician groups, insurers, life sciences companies, and a range of health care providers. She has particularly extensive knowledge of health care compliance issues. She has helped clients navigate federal and state regulations regarding the Stark Law, Anti-Kickback Statute, anti-markup rule, account billing laws, corporate practice of medicine, Medicare reimbursement, Physician Payments Sunshine Act, certificate of need requirements, HIPAA, and the HITECH Act. She has also counseled clients on responding to government and insurance company audit requests.

    Click here for more information about Sarah.

  • Neal I. Fowler

    Neal I. Fowler, United States Attorney's Office, Raleigh

  • John B. Garver III

    John B. Garver III, Robinson Bradshaw & Hinson PA, Charlotte

    John practices in the areas of health care, joint ventures and insurance law. He has a broad transactional health care practice, including assisting hospitals and health systems, physicians and their practices, and dialysis providers in structuring and closing acquisitions, affiliations, joint ventures and ownership transfers. John also advises clients on compliance and regulatory issues, including the Anti-Kickback and Stark laws, self-audits, overpayments and self-reporting. He served as a longtime leader of the firm's Health Care Practice Group and frequently writes and speaks on health law issues.

    Click here for more information about John.

  • Barry S. Herrin

    Barry S. Herrin, Herrin Health Law PC, Atlanta, GA

    Barry's practice is devoted primarily to health care and hospital law and policy, privacy law, and representation of tax-exempt healthcare organizations, with a particular emphasis in operational and governance issues, transactional matters, health information management and privacy issues, general compliance matters, and the establishment of physician-hospital collaboratives such as accountable care organizations, integrated delivery systems, joint ventured insurance entities, and jointly owned ambulatory surgery centers.

    Click here for more information about Barry.

  • Pearlynn G. Houck

    Pearlynn G. Houck, Robinson Bradshaw & Hinson PA, Charlotte

    Pearlynn is a versatile litigator and adviser. She represents companies and executives in complex business disputes, investigations and bet-the-company litigation. She has experience in matters involving fraud, breach of contract, unfair trade practices, financial products, securities, corporate governance, professional negligence and class actions.

    Click here for more information about Pearlynn.

  • Kelsey U. Jernigan

    Kelsey U. Jernigan, K&L Gates LLP, Research Triangle Park

    Kelsey is an associate in the firm's Research Triangle Park office. Kelsey's practice focuses on health care regulatory and transactional law for hospitals, health systems, and other health care providers. Her scope of work includes analysis of potential Stark Law and Anti-Kickback matters; government investigation and inquiries; assistance with the submission of appeals to Administrative Law Judges in connection with the Recovery Audit Contractor (RAC) program; and assisting clients with various operational matters, including contracting, medical staff issues, and risk management issues.

    Click here for more information about Kelsey.

  • Jonathan C. Krisko

    Jonathan C. Krisko, Robinson Bradshaw & Hinson PA, Charlotte

    Jon represents clients in complex, business-related litigation, which has included matters involving health care, product liability, technology, and government and regulatory investigations. His experience includes trials, arbitrations and appeals in federal and state courts.

    Click here for more information about Jon.

  • Ted Lotchin

    Ted Lotchin, WakeMed Health & Hospitals, Raleigh

    Click here for more information about Ted.

  • Jennifer B. "Jenny" Markham

    Jennifer B. "Jenny" Markham, UNC Healthcare System, Chapel Hill

    Click here for more information about Jenny.

  • Allen T. O'Rourke

    Allen T. O'Rourke co-chairs the Cybersecurity and Privacy Practice Group at Robinson Bradshaw and is an IAPP Certified Information Privacy Professional (CIPP/US and CIPP/Europe). He leads cyber investigations, helps clients respond to data breaches, and represents clients facing lawsuits and government investigations arising out of cybersecurity incidents. Allen also provides legal guidance on privacy and data security law as well as digital advertising and analytics.

    Before entering private practice, Allen was a cybercrime prosecutor who helped lead the Cyber Unit at the US Attorney's Office in Washington, DC, where he received two Special Achievement Awards for his work to combat cybercrime.

    Click here for more information about Allen.

  • Karishma S. Page

    Karishma S. Page, K&L Gates LLP, Washington, DC

    Karishma is a member of the firm's public policy and law practice. Karishma concentrates her practice on federal legislative and regulatory policy, focusing on tax, financial services, health care, retirement, and employee benefits issues. She has extensive experience working on a variety of legislation, such as the Tax Cuts and Jobs Act, the Protecting Americans from Tax Hikes Act, the Dodd-Frank Wall Street Reform and Consumer Protection Act, and the Affordable Care Act. She also works on related rulemaking and regulatory activity.

    Click here for more information about Karishma.

  • Steven G. "Steve" Pine

    Steven G. "Steve" Pine, K&L Gates LLP, Research Triangle Park

    Steve is a partner in the firm's health care practice group. He concentrates his practice on the intersection of health law compliance and dispute resolution, primarily representing public and private academic medical centers, hospitals, and health systems. His areas of focus include certificate of need contested cases; governmental and nongovernmental payment and reimbursement; health privacy; HIPAA and Common Rule research compliance; clinically integrated network (CIN) formation; alternative payment models and value-based reimbursement; federal False Claims Act litigation; administrative reconsiderations, reviews and appeals (e.g., EMTALA QIO hearings, RAC appeals and hearings, UPIC/ZPIC appeals); and Affordable Care Act compliance.

    Click here for more information about Steve.

  • David A. Senter Jr.

    David A. Senter Jr., Young Moore and Henderson PA, Raleigh

    David is a shareholder at Young Moore in Raleigh and focuses his practice on the healthcare and transportation industries. He educates and advises clients in matters pertaining to healthcare privacy and data security, breach notification and reporting requirements, and Health Insurance Portability and Accountability Act (HIPAA) compliance. David currently serves as the Interim Associate Compliance Officer and Director of Privacy of an Academic Medical Center in North Carolina.

    Click here for more information about David.

April 23, 2021
Fri 8:55 AM EDT

Duration 7H 5M

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